Vinke Petra C, Navis Gerjan, Kromhout Daan, Corpeleijn Eva
Department of Epidemiology, University Medical Center Groningen, University of Groningen (FA40), P.O. Box 30 001, 9700 RB Groningen, the Netherlands.
Department of Nephrology, University Medical Center Groningen, University of Groningen (AA52), P.O. Box 30 001, 9700 RB Groningen, the Netherlands.
EClinicalMedicine. 2020 Jan 15;19:100252. doi: 10.1016/j.eclinm.2019.100252. eCollection 2020 Feb.
It is unknown whether a socio-economic difference exists in the association of diet quality with type 2 diabetes incidence, nor how diet influences the socioeconomic inequality in diabetes burden.
In 91,025 participants of the population-based Lifelines Cohort (aged ≥30, no diabetes or cardiovascular diseases at baseline), type 2 diabetes incidence was based on self-report, fasting glucose ≥ 7·0 mmol/l and/or HbA1c ≥ 6·5%. The evidence-based Lifelines Diet Score was calculated with data of a 110-item food frequency questionnaire. Socio-economic status (SES) was defined by educational level. Cox proportional hazards models were adjusted for age, gender, smoking, energy intake, alcohol intake and physical activity.
In 279,796 person-years of follow-up, 1045 diabetes cases were identified. Incidence rate was 5·7, 3·2 and 2·4 cases/1000 person-years in low, middle and high SES, respectively. Diet was associated with greater diabetes risk (HR(95%CI) in Q1 (poor diet quality) vs. Q5 (high diet quality) = 2·11 (1·70-2·62)). SES was a moderator of the association(p = 0·038). HRs for Q1 vs. Q5 were 1·66 (1·22-2·.27) in low, 2·76 (1·86-4·08) in middle and 2·46 (1·53-3·97) in high SES. With population attributable fractions of 14·8%, 40·1% and 37·3%, the expected number of cases/1000 person-years preventable by diet quality improvement was 0·85 in low, 1·28 in middle and 0·90 in high SES.
Diet quality improvement can potentially prevent one in three cases of type 2 diabetes, but because of a smaller impact in low SES, it will not narrow the socioeconomic health gap in diabetes burden.
None.
饮食质量与2型糖尿病发病率之间的关联是否存在社会经济差异，以及饮食如何影响糖尿病负担中的社会经济不平等尚不清楚。
在基于人群的生命线队列研究的91025名参与者（年龄≥30岁，基线时无糖尿病或心血管疾病）中，2型糖尿病发病率基于自我报告、空腹血糖≥7.0 mmol/L和/或糖化血红蛋白≥6.5%。基于110项食物频率问卷的数据计算循证生命线饮食评分。社会经济地位（SES）由教育水平定义。Cox比例风险模型针对年龄、性别、吸烟、能量摄入、酒精摄入和身体活动进行了调整。
在279796人年的随访中，共确诊1045例糖尿病病例。低、中、高社会经济地位组的发病率分别为5.7、3.2和2.4例/1000人年。饮食与更高的糖尿病风险相关（第一四分位数（饮食质量差）与第五四分位数（饮食质量高）相比，HR（95%CI）=2.11（1.70 - 2.62））。社会经济地位是该关联的调节因素（p = 0.038）。第一四分位数与第五四分位数相比的HR在低社会经济地位组为1.66（1.22 - 2.27），在中社会经济地位组为2.76（1.86 - 4.08），在高社会经济地位组为2.46（1.53 - 3.97）。饮食质量改善可预防的病例数/1000人年的预期数量在低社会经济地位组为0.85，在中社会经济地位组为1.28，在高社会经济地位组为0.90，人群归因分数分别为14.8%、40.1%和37.3%。
改善饮食质量有可能预防三分之一的2型糖尿病病例，但由于对低社会经济地位组的影响较小，它不会缩小糖尿病负担方面的社会经济健康差距。
无。
